|Número de publicación||US7229465 B2|
|Tipo de publicación||Concesión|
|Número de solicitud||US 10/113,096|
|Fecha de publicación||12 Jun 2007|
|Fecha de presentación||28 Mar 2002|
|Fecha de prioridad||28 Mar 2001|
|También publicado como||CA2442338A1, CA2442338C, CA2442341A1, CA2442341C, CA2442362A1, CA2442362C, EP1377223A2, EP1381318A2, EP1381318A4, EP1387642A2, EP1387642A4, US6905506, US7594890, US20020165579, US20020183771, US20020188306, US20050228416, WO2002078521A2, WO2002078521A3, WO2002078522A2, WO2002078522A3, WO2002078522B1, WO2002078549A2, WO2002078549A3|
|Número de publicación||10113096, 113096, US 7229465 B2, US 7229465B2, US-B2-7229465, US7229465 B2, US7229465B2|
|Inventores||Fred H. Burbank, Michael L. Jones, R. J. Serra, Greig Altieri, Jill Uyeno, Yu-Tung Wong, Randy Werneth|
|Cesionario original||Vascular Control Systems, Inc.|
|Exportar cita||BiBTeX, EndNote, RefMan|
|Citas de patentes (105), Otras citas (27), Citada por (26), Clasificaciones (37), Eventos legales (6)|
|Enlaces externos: USPTO, Cesión de USPTO, Espacenet|
This application is related to U.S. Provisional Application No. 60/279,477 filed Mar. 28, 2001, hereby incorporated by reference in its entirety and from which benefit is hereby claimed under 35 U.S.C. 119(e).
The invention relates generally to the field of treatment of diseases and conditions by regulation of blood flow; in particular, the treatment of a uterus by regulating blood flow thereto.
Hysterectomy (surgical removal of the uterus) is performed on approximately 600,000 women annually in the United States. For approximately 340,000 women, hysterectomy is probably the best current therapeutic choice for the treatment of their diseases (uterine cancer, endometriosis, menorrhagia, and prolapse). For approximately 60,000 women with dysfunctional uterine bleeding (abnormal menstrual bleeding that has no discrete anatomic explanation such as a tumor or growth), newer endometrial ablation techniques may be an alternative to hysterectomy. For approximately 200,000 women with benign but symptomatic (excessive bleeding, pain, and “bulk” sensations) muscular tumors of the uterus, known as leiomyoma or fibroids, newer treatment methods have been developed which may spare these women a hysterectomy, as well.
Hysterectomy for treating uterine fibroid disorders, though effective, has many undesirable characteristics. Thus, any method which can approximate the therapeutic result of a hysterectomy without removing the uterus (and commonly the ovaries since they are closely adjacent to the uterus) would be a significant improvement in this field.
The undesirable characteristics of hysterectomy include a known mortality rate of 0.5 deaths per 1000 hysterectomies. Stated another way, the risk of death within 30 days of hysterectomy is thirty times greater for women who have had a hysterectomy than for women of similar ages and backgrounds who have not had a hysterectomy. Morbidity (medical symptoms and problems short of death) associated with hysterectomy include possible injury to adjacent organs (the bladder, the ureters, and bowel), hospital stay of approximately one week, five to six weeks of slow recovery to normal activity, three weeks of absence from work, direct medical expenses of at least $10,000, indirect cost of time away from work, a future three-fold increase in the incidence of cardiovascular disease, decreased sexual pleasure in approximately thirty percent of women, and depression and anxiety for many years after the hysterectomy for approximately eight percent of women.
The endometrium is a glandular mucous membrane of the uterus, the thickness and structure of which varies with the phase of the menstrual lining. It is normal for portions of the lining to slough off and bleed during menstruation, but many women suffer from painful dysfunctional uterine bleeding or endometritis. Thus, endometrial ablation (removal or destruction of the endometrium) may be an alternative to hysterectomy for approximately 60,000 women. A great many new devices have been invented to perform endometrial ablation to treat dysfunctional uterine bleeding. To distinguish the present invention and its applications from endometrial ablation devices, the endometrial ablation devices will be briefly described. Endometrial devices can be categorized into two major groups: devices which require direct visualization of the endometrium to apply an energy source to ablate the endometrium; and those that do not require visualization for their application.
Direct visualization of the lining of the uterus is accomplished by placing a hysteroscope through the vagina and into the uterus via the cervical os (opening). The hysteroscope image is then displayed as a color image on a TV monitor adjacent to the patient. The gynecologist then manipulates the hysteroscope and endometrial ablation instrument to ablate the lining of the uterus. Endometrial lining ablation instruments directed by hysteroscope include radio frequency or electrosurgery loops, roller-balls, and lasers. The goal of all of these hysteroscopic endometrial ablation instruments is to transfer heat energy to the endometrium sufficiently to heat and thereby destroy it. An ablated endometrium cannot respond physiologically or pathologically to hormonal stimulation and cannot, therefore, proliferate and bleed.
To treat all of the endometrium, it must be entirely visible through the hysteroscope. However, visualization of all of the endometrium is difficult. The uterus must be distended like a water balloon to allow adequate visualization. In this distension process, some women become water intoxicated and hyponatremic. Furthermore, the uterine cavity is an awkward shape, somewhat triangular and often angulated. Directly visualizing each and every square millimeter of endometrial surface and ablating each and every square millimeter is seldom achieved. Consequently, portions of the dysfunctional endometrium may persist and dysfunctional bleeding may continue.
Because of these hysteroscopic visualization and ablation limitations, alternative methods have been invented to destroy the lining of the uterus without the need at all for visualization of the uterine lining. On such method uses a prototypic instrument, the ThermaChoice™ balloon, which is produced by GyneCare, a division of Ethicon, Inc. (see U.S. Pat. No. 5,776,129, incorporated in its entirety herein). This device is inserted through the vagina into the uterus via the cervical os. The balloon is shaped like a triangle to conform to the shape of the uterus. Once in place, hot fluid is added to the balloon to heat and destroy the uterine lining. Treatment only occurs where the balloon is in adequate contact with the uterine lining. As an alternative, hot fluids can be directly introduced into the uterus (e.g., ENABL brand system manufactured by Innerdyne, Inc., and marketed by U.S. Surgical Corporation).
Endometrial destruction can also be brought about with chemical damage, photochemical injury, or thermal damage (heat or cold). Energy that reaches and destroys the cells of the endometrial lining of the uterus potentially destroys the uterine lining and thereby treats dysfunctional uterine bleeding.
Surgically removing fibroids or in situ ablation of uterine fibroids is a bit like eradicating ants in the pantry—they are not all seen from one perspective and there may be a lot of them. Commonly, a diagnosis of uterine fibroids involves the presence of multiple fibroids, often averaging ten fibroids or more per afflicted uterus. Consequently, it is difficult to know which fibroid is causing symptoms to the patient (bleeding, pain, and bulk effects on adjacent organs). Furthermore, fibroids occur at different layers in the uterus. Uterine fibroids can occur adjacent to the lining of the uterus (submucosal fibroid), in the myometrium (intramural fibroid), or adjacent to the outer layer of the uterus (subserosal fibroid). Consequently, if one is directly observing the uterus from the peritoneal cavity, only subserosal fibroids would be seen. If one is directly observing the uterus from the endometrial surface of the uterus, only the submucosal would be seen. Fibroids deep within the wall of the uterus are poorly visualized from either surface. Finally, since fibroids come in all sizes, only the larger fibroids will be seen in any case.
Clearly, the strategy of identifying which individual fibroid is causing symptoms (when there are often many), finding that fibroid, and then either removing or destroying that individual fibroid is a rather complex strategy. It is therefore easy to understand why the hysterectomy is such a common surgical choice. With hysterectomy, all uterine fibroids are removed in one stroke.
In 1995, it was demonstrated that fibroids, in a uterus that contained one or multiple fibroids, could be treated without hysterectomy using a non-surgical therapy, specifically comprising bilateral intraluminal occlusion of the uterine arteries (Ravina et al., “Arterial Embolization to Treat Uterine Myomata”, Lancet Sep. 9, 1995; Vol. 346; pp. 671–672, incorporated in its entirety herein). This technique is known as “uterine artery embolization”. The technique uses standard interventional radiology angiographic techniques and equipment, whereby the uterine arteries are accessed via a transvascular route from a common femoral artery into the left and right uterine arteries.
Three facts explain the success of uterine artery embolization. First, it has been established that pelvic bleeding from a wide variety of sources (e.g., auto accidents, surgical errors, and post partum hemorrhage) can be effectively controlled with embolization techniques using coils placed in arterial and venous lumens (U.S. Pat. Nos. 4,994,069, 5,226,911, and 5,549,824, all of which are incorporated in their entireties herein) (available from Target Therapeutics), or particles (GELFOAM pledgets, available from Upjohn, Kalamazoo, Mich., or IVALON particles, available from Boston Scientific).
Second, fibroids live a tenuous vascular life with very little ability to recruit a new blood supply from the host when the primary blood supply is compromised. Third, the uterus has a dual (or redundant) blood supply, the primary blood supply being from the bilateral uterine arteries, and the secondary blood supply from the bilateral ovarian arteries.
Consequently, when both uterine arteries are occluded, i.e. bilateral vessel occlusion, the uterus and the fibroids contained within the uterus are both deprived of their blood supply. However, as demonstrated by Ravina et al., the effect on the fibroid is greater than the effect on the uterus. In most instances, the fibroid withers and ceases to cause clinical symptoms.
The uterine artery embolization technique utilized by Ravina et al. uses standard transvascular equipment, available in typical interventional radiology angiography suite. This equipment includes guide catheters to selectively enter the tortuous right and left uterine arteries, Ivalon or Gelfoam particles, and intravascular coils. With skill and these standard angiographic tools, the uterine arteries can be occluded bilaterally and fibroid disease treated through a 2 mm hole in the right groin and through the right common femoral artery. Following the procedure, the arterial puncture site is held with manual pressure for fifteen minutes. While post-procedural pain is often significant, and requires intravenously delivered pain medication, the patient is typically fully recovered in a few days.
One problem with present methods of uterine artery embolization is that many physicians do not possess the skill or equipment necessary to perform catheter-based uterine artery embolization under radiologic direction. Accordingly, only hundreds of uterine artery embolizations have been performed, worldwide, over the past three years, whereas hundreds of thousands of hysterectomies have been performed each year for uterine fibroids which are symptomatic.
What is needed, therefore, are devices and methods to occlude arteries such as the uterine arteries.
The invention is directed to devices, systems and methods for occluding arteries such as the uterine arteries. In particular, the invention is directed to devices, systems and methods for occluding arteries from outside the arteries; that is, to devices, systems and methods configured to be applied to arteries externally of the arteries. Occlusion may be temporary or permanent, and may be partial or complete. One method of occluding an artery comprises clamping the artery so that blood flow through the artery is reduced, or is completely stopped. Such clamping of an artery may be direct or may be indirect. Thus, clamping of an artery may be accomplished by applying a clamping device directly onto an artery effective to compress the artery, or may be accomplished by applying a clamping device to tissue near to an artery effective to compress the artery.
Clamping devices embodying features of the invention include clamping devices having a clamping member configured to apply pressure to a blood vessel and a blood flow sensor. A clamping member may have a distal portion configured to engage tissue. Clamping devices embodying features of the invention may have two, or more, clamping members. Two clamping members maybe disposed opposite each other and configured to move or apply pressure towards each other, such as to close together, effective to engage tissue and to clamp a blood vessel between them. Alternatively, a clamping member may have two portions disposed in apposition to one another, effective to clamp tissue between the portions.
A blood flow sensor preferably includes doppler ultrasound sensor. A blood flow sensor may be disposed on a clamping member, preferably on a distal portion configured to engage tissue, more preferably near the middle of the distal portion. A blood flow sensor disposed on a clamping member may be configured to detect blood flow in a blood vessel near said clamping member, and may be configured to detect blood flow in a blood vessel clamped by a clamping member. Clamping devices embodying features of the invention may include more than one blood flow sensor.
Clamping devices may be configured to be held by a clamping device applicator. A clamping device applicator embodying features of the invention may be used to deliver a clamping device to a desired location. A clamping device applicator includes an engagement member configured to hold and to release a clamping device, and a delivery member configured to deliver a clamping device to a desired location. A clamping device applicator may be used to close together clamping members of a clamping device, to apply pressure to clamping members, and to apply pressure to tissue disposed between clamping members of a clamping device. A clamping device applicator may include an elongated arm or arms effective to place a clamping device at a desired location within a patient's body, such as adjacent a vaginal wall within a vagina near to a uterine artery.
Clamping device embodying features of the invention may be configured to lock into a clamping position. Such a locked configuration may be temporary and releasable, or may be permanent. Clamping devices embodying features of the invention may have a ratchet mechanism configured to hold at least one clamping member in a clamping position; such ratchet mechanisms may be releasable ratchet mechanisms.
Clamping devices embodying features of the invention may include a release mechanism configured to release a locking mechanism such as a ratchet effective to release the clamping of a blood vessel. Clamping devices embodying features of the invention may include a recovery member configured to aid the removal of the clamping device from a patient and the recovery of the device after release of the clamping of a blood vessel. For example, a recovery member may include a lanyard or other cord or cable device.
The invention further provides systems for occluding a blood vessel, including a clamping device having a clamping member configured to apply pressure to a blood vessel, and a blood flow sensor, and a clamping device applicator configured to engage a clamping device. The blood flow sensor in such systems is preferably a doppler ultrasound sensor.
Methods and devices embodying features of the invention may be used to occlude any artery; in the following discussion, the uterine artery is used as an example. It will be understood that the methods and devices discussed in regard to this example may also be applied to any other artery.
One method of occluding a uterine artery includes applying a clamping device to the artery so that blood flow through the artery is reduced, or is completely stopped. Such clamping of a uterine artery may be direct or may be indirect. Clamping of the artery may be accomplished by applying a clamping device directly onto a uterine artery effective to compress the uterine artery, or may be accomplished by applying a clamping device to tissue near to a uterine artery effective to compress the uterine artery.
A method of occluding an artery includes sensing an artery, and compressing an artery with a clamping device having a blood flow sensor. Sensing an artery may include sensing blood flow, such as blood flow in an artery. Compressing an artery may include grasping tissue near to an artery, and may include compressing tissue surrounding an artery effective to compress the artery.
Thus, a method of occluding a uterine artery includes sensing a uterine artery, and compressing a uterine artery with a clamping device having a blood flow sensor. Accessing a uterine artery may include accessing a uterine artery via the vagina of a patient with a uterine artery. Compressing a uterine artery may include grasping tissue near to a uterine artery, and may include compressing tissue surrounding a uterine artery effective to compress the uterine artery. A method of occluding a uterine artery includes accessing a uterine artery via a vagina, and compressing a portion of a vagina wall with a clamping device having a blood flow sensor. A method of occluding uterine artery may also include sensing blood flow in a uterine artery. Sensing blood flow in a uterine artery may include sensing blood flow in a uterine artery through a wall of a vagina. A method of occluding blood flow in a uterine artery may include sensing a reduction or cessation of blood flow following application of a clamping device.
A method of occluding a uterine artery includes applying a clamping device having a blood flow sensor to the artery so that blood flow through the artery is reduced, or is completely stopped, and the reduction or cessation of blood flow is sensed by the blood flow sensor. A blood flow sensor is also effective to locate the artery by sensing blood flow before application of the clamping device. A particularly suitable blood flow sensor is a doppler ultrasound sensor. A uterine artery may be clamped effective to compress the uterine artery by applying a clamping device directly onto a uterine artery, or by applying a clamping device to tissue near to a uterine artery.
A method of occluding a uterine artery of a patient includes compressing a portion of a uterine artery with a clamping device comprising a blood flow sensor, and sensing a level of blood flow in the artery with said blood flow sensor. For example, the method may include sensing blood flow in a uterine artery effective to locate a uterine artery. A uterine artery may be accessed via the vagina of a patient, and compressing a uterine artery may be accomplished by compressing a portion of the vaginal wall around a portion of a uterine artery. A clamping device suitable for use in a method embodying features of the invention may be a releasable clamping device, so that a uterine artery may remain occluded for only a limited time. A suitable limited time may be between about 0.2 hours and about 12 hours, or preferably between about 0.5 hours and about 4 hours.
The devices, systems and methods of the present invention may be used to occlude blood flow in arteries without need for invasive procedures such as puncturing skin or vessel walls. For example, clamping a vaginal wall around a uterine artery is effective to occlude blood flow in that uterine artery without puncturing the skin or a blood vessel of the patient. Such occlusion may be used to treat uterine disorders such as, for example, uterine fibroids, dysfunctional uterine bleeding, and other uterine disorders.
The devices, systems and methods of the present invention provide the advantages of allowing for the occlusion of an artery without puncture of bodily tissue, and allowing for arterial occlusion without need for radiographic equipment or skill in the use of radiographic techniques. The devices and methods are simpler and more readily used and removed than other methods and devices, and provide improved treatments for serious conditions and diseases.
A clamp device applicator 14 is configured to hold a clamp 12 and to deliver it to a desired location, and optionally to apply force effective to compress tissue and optionally to lock a clamp 12 into a desired configuration. The clamp applicator 14 shown in
Clamping devices embodying features of the invention include clamps, ratchets, jaws, clips, wires, sutures, coils, or other structures or devices. Clamping devices preferably include at least one clamping member configured to directly or indirectly apply pressure to a blood vessel or to urge movement of a blood vessel. Clamping devices may also include a clamping surface, such as an anvil, against which a blood vessel may be directly or indirectly urged. A clamping member may serve as a clamping surface for another clamping member. A clamping member may be configured to urge a blood vessel towards a clamping surface or towards another clamping member. Methods for applying clamping devices include grasping, probing, penetrating, deflecting, invaginating, and dilating tissue or vessels.
Clamping devices embodying features of the invention may also include at least one blood flow sensor configured to sense blood flow in vessels. A blood flow sensor is preferably disposed on a clamping member, such as a jaw of a clamp, in a position to sense blood flow near a clamping member when the clamping device is near to a blood vessel, and in a position to contact a blood vessel when the clamping device is applied directly to a blood vessel. Alternatively, a blood flow sensor may be disposed on a clamping surface, or other location on a clamping device effective to sense blood flow in vessels near the clamping device and to aid in guiding the clamping device to a desired location near a blood vessel. A particularly suitable blood flow sensor is a doppler ultrasound sensor.
Clamping devices may be of any suitable size, which is determined in part by the location and dimension of the artery to be occluded. For accessing and occluding a uterine artery, the dimensions of a vagina help to determine suitable sizes for clamping devices and clamp applicators embodying features of the invention. For example, a clamping device may be between about 2 cm and about 20 cm in length, preferably between about 3 cm and about 15 cm in length.
A clamping device may be applied alone, or may be applied with a clamping device applicator. A clamping device that is applied to a blood vessel using a clamping device applicator may be configured to be received by the applicator, and to be applied by it. A clamping device applied by an applicator may have a clamping member configured to move under the influence of a clamping device applicator. Where a clamping device has a plurality of clamping members, some clamping members may be configured to close or to close together under the influence of a clamping device applicator.
Clamping devices embodying features of the invention may be made from any suitable material or combination of materials, including metals such as stainless steel and shape memory alloys such as nickel titanium alloys, plastics, ceramics, and other biocompatible materials known in the art. Biocompatible polymers, such as for example, polycarbonate, polysulfone, polyester, polyacetal, and other polymers may be particularly suitable for embodiments of the invention.
Blood flow sensors may be any blood flow sensor. Preferred blood flow sensors include doppler or near infra-red blood flow sensors. A sensing box may be included to receive and process data in the analysis of blood flow. A clamping system may be configured to provide Doppler, near infra-red spectrometric imaging of arteries to non-destructively locate and ligate or occlude identified arteries. The device or system may be designed for single use (disposable) or may be sterilizable and capable of multiple use.
|Patente citada||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US2400251||29 Jul 1943||14 May 1946||Nagel Charles E||Gynecological instrument|
|US3411505||15 Dic 1965||19 Nov 1968||Paul D. Nobis||Device for interrupting arterial flow|
|US3777740||21 Oct 1971||11 Dic 1973||Administrator For Veterans Aff||Method and apparatus for non-invasively visualizing blood vessels|
|US3779248||18 Oct 1971||18 Dic 1973||Medical Concepts Inc||Forceps|
|US4120302||8 Oct 1976||17 Oct 1978||American Hospital Supply Corporation||Disposable pads for surgical instruments|
|US4226240||30 May 1979||7 Oct 1980||Walker Jr William E||Surgical foreceps|
|US4292960||30 Abr 1979||6 Oct 1981||Rca Corporation||Apparatus and method for application of radioactive and microwave energy to the body|
|US4428374||11 Jul 1980||31 Ene 1984||Auburn Robert M||Umbilical cord clamping assembly|
|US4428379||7 Ene 1982||31 Ene 1984||Technicare Corporation||Passive ultrasound needle probe locator|
|US4454767 *||23 Mar 1981||19 Jun 1984||Fuji Electric Co., Ltd.||Ultrasonic metering device|
|US4509528||15 Jul 1982||9 Abr 1985||Harvinder Sahota||Hemostat with blood flow sensor|
|US4589419||1 Nov 1984||20 May 1986||University Of Iowa Research Foundation||Catheter for treating arterial occlusion|
|US4650466||1 Nov 1985||17 Mar 1987||Angiobrade Partners||Angioplasty device|
|US4757823||27 Ene 1987||19 Jul 1988||Hofmeister John F||Method and apparatus for measuring uterine blood flow|
|US4770175 *||22 Oct 1986||13 Sep 1988||Western Clinical Engineering Ltd.||Occlusive cuff|
|US4771788||3 Ago 1987||20 Sep 1988||Pfizer Hospital Products Group, Inc.||Doppler tip wire guide|
|US4945896||24 Ene 1989||7 Ago 1990||Gade George F||Surgical retractor assembly having tissue viability sensor embedded therein|
|US4994069||2 Nov 1988||19 Feb 1991||Target Therapeutics||Vaso-occlusion coil and method|
|US5037430||17 Jul 1987||6 Ago 1991||Hasson Harrith M||Clamp for gynecological instruments|
|US5081997||20 Jul 1989||21 Ene 1992||Vance Products Incorporated||Echogenic devices, material and method|
|US5108408||20 Abr 1990||28 Abr 1992||Lally James J||Uterine-ring hysterectomy clamp|
|US5197972 *||25 Mar 1991||30 Mar 1993||Hakki A Hamid||Arterial manometric dressing|
|US5201314||21 Ene 1992||13 Abr 1993||Vance Products Incorporated||Echogenic devices, material and method|
|US5226911||2 Oct 1991||13 Jul 1993||Target Therapeutics||Vasoocclusion coil with attached fibrous element(s)|
|US5275166||16 Nov 1992||4 Ene 1994||Ethicon, Inc.||Method and apparatus for performing ultrasonic assisted surgical procedures|
|US5277181||12 Dic 1991||11 Ene 1994||Vivascan Corporation||Noninvasive measurement of hematocrit and hemoglobin content by differential optical analysis|
|US5289821 *||30 Jun 1993||1 Mar 1994||Swartz William M||Method of ultrasonic Doppler monitoring of blood flow in a blood vessel|
|US5289831||21 Abr 1992||1 Mar 1994||Vance Products Incorporated||Surface-treated stent, catheter, cannula, and the like|
|US5336231||23 Nov 1992||9 Ago 1994||Adair Edwin Lloyd||Parallel channel fixation, repair and ligation suture device|
|US5368034||4 Sep 1992||29 Nov 1994||Boston Scientific Corporation||Method and apparatus for thrombolytic therapy|
|US5383922||15 Mar 1993||24 Ene 1995||Medtronic, Inc.||RF lead fixation and implantable lead|
|US5427108||31 Mar 1994||27 Jun 1995||Bollinger; Armin||Ultrasonic Doppler probe with needle guide|
|US5456693||25 Ago 1994||10 Oct 1995||Vitaphore Corporation||Embolization plugs for blood vessels|
|US5458596||6 May 1994||17 Oct 1995||Dorsal Orthopedic Corporation||Method and apparatus for controlled contraction of soft tissue|
|US5488958||7 Nov 1994||6 Feb 1996||Vance Products Incorporated||Surgical cutting instrument for coring tissue affixed thereto|
|US5507744||30 Abr 1993||16 Abr 1996||Scimed Life Systems, Inc.||Apparatus and method for sealing vascular punctures|
|US5542944||23 Sep 1994||6 Ago 1996||Bhatta; Krishan M.||Surgical device and method|
|US5549624||24 Jun 1994||27 Ago 1996||Target Therapeutics, Inc.||Fibered vasooclusion coils|
|US5549824||2 Mar 1995||27 Ago 1996||Ing. A. Maurer Sa||Filter apparatus including stacked intake and discharge plates|
|US5556396||28 Mar 1995||17 Sep 1996||Endovascular, Inc.||Method for tubal electroligation|
|US5562680||20 Mar 1995||8 Oct 1996||Hasson; Harrith M.||Apparatus for assisting the performance of pelvic endoscopic procedures|
|US5582617||11 Oct 1994||10 Dic 1996||Charles H. Klieman||Surgical instrument for endoscopic and general surgery|
|US5588960||1 Dic 1994||31 Dic 1996||Vidamed, Inc.||Transurethral needle delivery device with cystoscope and method for treatment of urinary incontinence|
|US5598841||15 Sep 1994||4 Feb 1997||Kowa Company Ltd.||Blood flow measurement system|
|US5614204||23 Ene 1995||25 Mar 1997||The Regents Of The University Of California||Angiographic vascular occlusion agents and a method for hemostatic occlusion|
|US5662680||28 Oct 1994||2 Sep 1997||Desai; Ashvin H.||Endoscopic surgical instrument|
|US5672153||26 Sep 1994||30 Sep 1997||Vidamed, Inc.||Medical probe device and method|
|US5674243||3 Ago 1995||7 Oct 1997||Hale; Theodore Mark||Obstetrical forceps|
|US5691314||18 Mar 1996||25 Nov 1997||The Medical College Of Hampton Roads||Adjunctive therapy|
|US5697937||23 Feb 1996||16 Dic 1997||Toma; Doina||Surgical clamp with manipulable guide means|
|US5697942||15 Nov 1996||16 Dic 1997||Palti; Yoram||Internal vascular clamp|
|US5713371||7 Jul 1995||3 Feb 1998||Sherman; Dani||Method of monitoring cervical dilatation during labor, and ultrasound transducer particularly useful in such method|
|US5713896||10 May 1995||3 Feb 1998||Medical Scientific, Inc.||Impedance feedback electrosurgical system|
|US5713942||7 Jun 1995||3 Feb 1998||Vesta Medical, Inc.||Body cavity ablation apparatus and model|
|US5715832||28 Feb 1995||10 Feb 1998||Boston Scientific Corporation||Deflectable biopsy catheter|
|US5716389||13 Nov 1995||10 Feb 1998||Walinsky; Paul||Cardiac ablation catheter arrangement with movable guidewire|
|US5720743||7 Jun 1996||24 Feb 1998||Bischof; John C.||Thermally insulating surgical probe|
|US5747637||28 Ago 1996||5 May 1998||Mitsui Toatsu Chemicals, Inc.||Bioabsorbable polymer and process for preparing the same|
|US5759154||23 Dic 1996||2 Jun 1998||C. R. Bard, Inc.||Print mask technique for echogenic enhancement of a medical device|
|US5766135||17 Oct 1996||16 Jun 1998||Terwilliger; Richard A.||Echogenic needle tip|
|US5769791 *||7 Jun 1995||23 Jun 1998||Sextant Medical Corporation||Tissue interrogating device and methods|
|US5776129||12 Jun 1996||7 Jul 1998||Ethicon Endo-Surgery, Inc.||Endometrial ablation apparatus and method|
|US5792059||26 Nov 1996||11 Ago 1998||Esaote S.P.A.||Intraoperative probe, specifically intended for direct-contact observations|
|US5797397||25 Nov 1996||25 Ago 1998||Hewlett-Packard Company||Ultrasound imaging system and method using intensity highlighting to facilitate tissue differentiation|
|US5800378||20 Mar 1996||1 Sep 1998||Vidamed, Inc.||Medical probe device and method|
|US5817022||11 Mar 1997||6 Oct 1998||Sonometrics Corporation||System for displaying a 2-D ultrasound image within a 3-D viewing environment|
|US5836906||22 May 1996||17 Nov 1998||Somnus Medical Technologies, Inc.||Method and apparatus for treatment of air way obstructions|
|US5840033||16 May 1997||24 Nov 1998||Ge Yokogawa Medical Systems, Limited||Method and apparatus for ultrasound imaging|
|US5895386||20 Dic 1996||20 Abr 1999||Electroscope, Inc.||Bipolar coagulation apparatus and method for arthroscopy|
|US5899861||8 Oct 1996||4 May 1999||Siemens Medical Systems, Inc.||3-dimensional volume by aggregating ultrasound fields of view|
|US5910484||30 May 1997||8 Jun 1999||The General Hospital Corporation||Treatment of ischemic cardiac malfunction|
|US5911691||21 May 1997||15 Jun 1999||Aloka Co., Ltd.||Ultrasound image processing apparatus and method of forming and displaying ultrasound images by the apparatus|
|US5916173||26 Feb 1997||29 Jun 1999||Kirsner; Vaclav||Methods and apparatus for monitoring fertility status in the mammalian vagina|
|US5921933||17 Ago 1998||13 Jul 1999||Medtronic, Inc.||Medical devices with echogenic coatings|
|US5922008||28 Ago 1997||13 Jul 1999||Gimpelson; Richard J.||Surgical forceps|
|US5941889||14 Oct 1997||24 Ago 1999||Civco Medical Instruments Inc.||Multiple angle disposable needle guide system|
|US5979453||6 Nov 1996||9 Nov 1999||Femrx, Inc.||Needle myolysis system for uterine fibriods|
|US6013088||17 Nov 1998||11 Ene 2000||Karavidas; Theocharis||Surgical clamp with removable tips|
|US6015541||3 Nov 1997||18 Ene 2000||Micro Therapeutics, Inc.||Radioactive embolizing compositions|
|US6019724||8 Feb 1996||1 Feb 2000||Gronningsaeter; Aage||Method for ultrasound guidance during clinical procedures|
|US6032673||15 Ago 1997||7 Mar 2000||Femrx, Inc.||Methods and devices for tissue removal|
|US6033398||4 Mar 1997||7 Mar 2000||Vnus Medical Technologies, Inc.||Method and apparatus for treating venous insufficiency using directionally applied energy|
|US6034477||8 Dic 1998||7 Mar 2000||U.S. Philips Corporation||High-pressure discharge lamp|
|US6035238||13 Ago 1997||7 Mar 2000||Surx, Inc.||Noninvasive devices, methods, and systems for shrinking of tissues|
|US6045508||27 Feb 1997||4 Abr 2000||Acuson Corporation||Ultrasonic probe, system and method for two-dimensional imaging or three-dimensional reconstruction|
|US6066139||14 May 1996||23 May 2000||Sherwood Services Ag||Apparatus and method for sterilization and embolization|
|US6077257||20 Sep 1996||20 Jun 2000||Vidacare, Inc.||Ablation of rectal and other internal body structures|
|US6080118||25 Feb 1999||27 Jun 2000||Blythe; Cleveland||Vaginal probe and method of using same|
|US6106473||6 Nov 1997||22 Ago 2000||Sts Biopolymers, Inc.||Echogenic coatings|
|US6152874||25 Sep 1997||28 Nov 2000||Genzyme Corporation||Adjustable multi-purpose coronary stabilizing retractor|
|US6169914||13 Ene 1999||2 Ene 2001||Urometrics, Inc.||Devices and methods for monitoring female arousal|
|US6175751||16 Mar 1999||16 Ene 2001||Allen Maizes||Apparatus and method for sensing oxygen levels in a fetus|
|US6210330||4 Ago 1999||3 Abr 2001||Rontech Medical Ltd.||Apparatus, system and method for real-time endovaginal sonography guidance of intra-uterine, cervical and tubal procedures|
|US6231515||13 Ene 1999||15 May 2001||Scimed Life Systems, Inc.||Safety mechanism and method to prevent rotating imaging guide device from exiting a catheter|
|US6254601||8 Dic 1998||3 Jul 2001||Hysterx, Inc.||Methods for occlusion of the uterine arteries|
|US6261234||7 May 1998||17 Jul 2001||Diasonics Ultrasound, Inc.||Method and apparatus for ultrasound imaging with biplane instrument guidance|
|US6280441||15 Dic 1997||28 Ago 2001||Sherwood Services Ag||Apparatus and method for RF lesioning|
|US6293954||21 Jun 1999||25 Sep 2001||Novare Surgical Systems, Inc.||Surgical clamp with replaceable clamp members|
|US6368340||4 Ene 1999||9 Abr 2002||William W. Malecki||Clamp assembly and method of use|
|US6371973||24 Ene 2000||16 Abr 2002||Ron-Tech Medical Ltd.||Forceps useful for intrabody guiding and/or positioning of a medical instrument|
|US6602251||17 Abr 2001||5 Ago 2003||Vascular Control Systems, Inc.||Device and methods for occlusion of the uterine artieries|
|US6610074||9 Feb 2001||26 Ago 2003||Albert N. Santilli||Aorta cross clamp assembly|
|US6635017||9 Feb 2000||21 Oct 2003||Spentech, Inc.||Method and apparatus combining diagnostic ultrasound with therapeutic ultrasound to enhance thrombolysis|
|US6709430 *||12 Dic 2000||23 Mar 2004||Transoma Medical, Inc.||Adjustable flow probe|
|US6905506||28 Mar 2002||14 Jun 2005||Vascular Control Systems, Inc.||Multi-axial uterine artery identification, characterization, and occlusion pivoting devices and methods|
|1||"Mick 200-TP Applicator Package", Mick Radio-Nuclear Instruments, Inc., advertisement.|
|2||"Multiplanar Biopsy Transverse Scan", Bruel & Kjaer Medical Systems, Inc., advertisement.|
|3||"Seeding Device-Proscan Urologic Ultrasound Imaging System", Teknar, advertisement.|
|4||"Transrectal Biopsy of the Prostrate Gland", Bruel & Kjaer Medical Systems, Inc., advertisement.|
|5||Barth, K.H. et al, Long Term Follow-up or Transcatheter Embolization with Autologous Clot, Oxygel and Gelform in Domestic Swine, Investigative Radiology, May-Jun. 1977, vol. 12, No. 2, pp. 277-278.|
|6||Bateman, William M.D., "Treatment of intractable menorrhagia by bilateral uterine vessel, Interruption", Am. J. Obst. & Gynec. 89(6):825-827 (Jul. 15, 1964).|
|7||Brigato, G. et al., "A Noninvasive Instrumental Method in Severe Postpartum Hemorrhages", Minerva Ginecologica 50(7-8):337-339 (1998).|
|8||Brohim, R.M. et al., "Development of Independent Vessel Security After Ligation With Absorbable Sutures or Clips", The American Journal of Surgery, Mar. 1993, vol. 165, pp. 345-349.|
|9||Burbank, Fred et al., "Uterine Artery Occlusion by Embolization or Surgery for the Treatment of Fibroids: A Unifying Hypothesis-Transient Uterine Ischemia", The Journal of the American Association of Gynecologic Laparoscopists, Nov. 2000, vol. 7, No. 7 Supplemental, pp. S3-S49.|
|10||Fuchs, Karl, "Afibrinogenemia Treated by Ligation of Uterine Arteries" Gynacologic 148:407-411 (1959).|
|11||Garza Leal, J. et al., "Myoma Treatment by Transient Uterine Ischemia" The Journal of the American Assoication of Gynecologic Laparoscopists 7(3):S31 (Aug. 2000).|
|12||Hay, D.L. et al., "Hemostasis in Blood Vessels After Ligation", Am. J. Obstet. Gynecol., Mar. 1989, 160:3, pp. 737-739.|
|13||Hunerbein, M. et al., "Endoscopic Ultrasound-Guided Real Time Biopsy of Peri-Intestinal Tumors", Surgical Technology International VII, 1998, pp. 91-95.|
|14||International Preliminary Report of Patentability for Serial No. PCT/US04/01935, mailed Jul. 8, 2005.|
|15||International Search Report for PCT/US02/09549, mailed Jun. 30, 2003.|
|16||International Search Report for PCT/US02/09775, mailed Sep. 12, 2002.|
|17||International Search Report for PCT/US03/35815 mailed Jun. 30, 2004.|
|18||International Search Report for PCT/US2004/038111, mailed May 3, 2005.|
|19||International Search Report for PCT/US2004/038276, mailed Mar. 15, 2005.|
|20||O'Leary, James A, M.D. "Uterine Artery Ligation in the Control of Postcesarean Hemorrhage" Am. J. Obst. & Gynec. 94(7):920-924 (Apr. 1, 1996).|
|21||O'Leary, James A., M.D., "Uterine Artery Ligation in the Control of Postcesarean Hemorrhage", The Journal of Reproductive Medicine, Inc., 40(3):189-193 (Mar. 1995).|
|22||O'Leary, James L., M.D. et al., "Uterine artery ligation in the control of intractable postpartum hemorrhage" Am. J. Obst. & Gynec. 94(7):920-924 (Apr. 1, 1966).|
|23||Ravina, J. H. et al., "Arterial embolisation to treat uterine myomata", The Lancet 346:671-672 (Sep. 9, 1995).|
|24||Schaefer, C.J. et al., "Absorbable Ligating Clips", Surg. Gynecol. Obstet., 1982, 154:513-516.|
|25||Sonopsy Ultrasound Guided Breast Biopsy, NeoVision, advertisement.|
|26||Translation for FR 1 220 773.|
|27||Written Opinion for PCT/US2004/038111, mailed May 3, 2005.|
|Patente citante||Fecha de presentación||Fecha de publicación||Solicitante||Título|
|US7431723 *||16 Jun 2004||7 Oct 2008||Depuy Products, Inc.||Device and method for separation of modular orthopaedic elements|
|US7594890 *||28 Mar 2002||29 Sep 2009||Vascular Control System, Inc.||Multi-axial uterine artery identification, characterization, and occlusion devices|
|US7771357 *||10 Jun 2003||10 Ago 2010||Vascular Control Systems, Inc.||Devices and methods for occlusion of the uterine arteries|
|US8216133 *||28 Feb 2007||10 Jul 2012||Chappuis James L||Doppler retractor|
|US8357176||18 Jul 2007||22 Ene 2013||Fibro Control, Inc.||Fibroid treatment apparatus and method|
|US8403837||1 Jun 2010||26 Mar 2013||Covidien Lp||Deployable jaws retraction device|
|US8403953||27 Jul 2009||26 Mar 2013||Fibro Control, Inc.||Balloon with rigid tube for occluding the uterine artery|
|US9486286||14 May 2008||8 Nov 2016||Boston Scientific Scimed, Inc.||Medical laser user interface|
|US20020165579 *||28 Mar 2002||7 Nov 2002||Burbank Fred H.||Multi-axial uterine artery identification, characterization, and occlusion devices and methods|
|US20030216759 *||10 Jun 2003||20 Nov 2003||Vascular Control Systems, Inc.||Devices and methods for occlusion of the uterine arteries|
|US20050038441 *||16 Jun 2004||17 Feb 2005||Hazebrouck Stephen A.||Device and method for separation of modular orthopaedic elements|
|US20070276188 *||28 Feb 2007||29 Nov 2007||Chappuis James L||Doppler retractor|
|US20080097473 *||30 Jul 2007||24 Abr 2008||Vascular Control Systems, Inc.||Treatment for post partum hemorrhage|
|US20080114382 *||5 Nov 2007||15 May 2008||Ams Research Corporation||Uterine Artery Ligation Devices and Methods|
|US20090054915 *||23 Ago 2007||26 Feb 2009||Peter Meier||Obstruction of uterine arteries to treat uterine fibroids using mechanical instruments to twist the vessels|
|US20090054916 *||23 Ago 2007||26 Feb 2009||Peter Meier||Clip-based method for treatment of uterine fibroids by obstruction of the uterine arteries|
|US20090062827 *||31 Ago 2007||5 Mar 2009||Peter Meier||Vacuum-based method for obstruction of uterine arteries to treat uterine fibroids|
|US20090093758 *||31 Oct 2006||9 Abr 2009||Yossi Gross||Fibroid treatment apparatus and method|
|US20090105698 *||14 May 2008||23 Abr 2009||Ams Research Corporation||Medical Laser User Interface|
|US20090157064 *||12 May 2008||18 Jun 2009||Hodel Michael R||RFID System and Method Therefor|
|US20090318950 *||18 Jul 2007||24 Dic 2009||Yossi Gross||Fibroid treatment apparatus and method|
|US20100249498 *||11 Mar 2010||30 Sep 2010||Tyco Healthcare Group Lp||Endoscopic Apparatus for Manipulating Tissue|
|US20110022073 *||27 Jul 2009||27 Ene 2011||Fibro Control, Inc.||Balloon with rigid tube for occluding the uterine artery|
|US20110040153 *||1 Jun 2010||17 Feb 2011||Tyco Healthcare Group Lp||Deployable jaws retraction device|
|US20110208237 *||4 Oct 2010||25 Ago 2011||Chi Mei Medical Center||Forceps for pathological diagnosis|
|US20170000525 *||15 Abr 2013||5 Ene 2017||Miriam Mackovic Basic||Instrument for occlusion of uterine blood vessels|
|Clasificación de EE.UU.||606/205, 606/119, 606/158, 600/504|
|Clasificación internacional||A61M25/00, A61B17/12, A61B18/00, A61B17/128, A61B17/122, A61B8/06, A61B5/026, A61B17/42, A61B17/00, A61B17/08, A61B5/02|
|Clasificación cooperativa||A61B2017/4216, A61B17/00234, A61B17/2812, A61B17/12, A61B8/06, A61B17/128, A61B2017/0046, A61B5/026, A61B17/42, A61B17/122, A61B17/1285, A61B8/12, A61B5/415, A61B5/418|
|Clasificación europea||A61B8/06, A61B8/12, A61B5/41J8, A61B5/41J2, A61B17/128E, A61B17/28D, A61B17/12, A61B17/122|
|8 Ago 2002||AS||Assignment|
Owner name: VASCULAR CONTROL SYSTEMS, INC., CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BURBANK, FRED H.;JONES, MICHAEL L.;SERRA, R.J.;AND OTHERS;REEL/FRAME:013175/0885;SIGNING DATES FROM 20020620 TO 20020628
|4 Nov 2002||AS||Assignment|
Owner name: VASCULAR CONTROL SYSTEMS, INC., CALIFORNIA
Free format text: CORRECTIV;ASSIGNORS:BURBANK, FRED H.;JONES, MICHAEL L.;SERRA, R. J.;AND OTHERS;REEL/FRAME:013884/0773
Effective date: 20020621
|10 Nov 2010||FPAY||Fee payment|
Year of fee payment: 4
|23 Ene 2015||REMI||Maintenance fee reminder mailed|
|12 Jun 2015||LAPS||Lapse for failure to pay maintenance fees|
|4 Ago 2015||FP||Expired due to failure to pay maintenance fee|
Effective date: 20150612